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Depression and anxiety symptoms across pregnancy and the postpartum in low-income Black and Latina women

Abstract

Underserved women of color experience high rates of perinatal affective disorders, but most research to date on the natural history of these disorders has been conducted on White women. The present study investigated longitudinal changes in anxiety and depression in a sample of perinatal non-Hispanic Black and Latina women. Categorical (yes/no) measures of positive anxiety and depression screens, as well as total symptom scores, were measured longitudinally across the perinatal period in 178 women (115 non-Hispanic Black, 63 Latina) using the CAT-MH™, a computerized adaptive test. Time (up to 4 visits) and race/ethnicity effects were assessed in linear mixed effects models. Rates of positive anxiety screenings were 13.6%, 3.2%, 8.5%, and 0% in Latina women and 2.6%, 4.2%, 6.1%, and 5.8% in non-Hispanic Black women in the 1st, 2nd, and 3rd trimesters, and postpartum, respectively. Rates of positive anxiety screenings overall were highest in the first trimester (OR = 0.20; 95% CI 0.04–0.98), and there was a significant time-by-race/ethnicity interaction for positive anxiety screens (OR = 8.88; 95% CI 1.42–55.51), as positive screens were most frequent in the first trimester and sharply declined for Latina women, while rates were relatively consistent across the perinatal period in non-Hispanic Black women. Rates of positive depression screens did not change over time, but there was a trend (OR = 1.93; 95% CI 0.93–4.03) for a time-by-race/ethnicity interaction in a direction similar to that seen for anxiety. The odds of positive anxiety screens vary by race/ethnicity and trimester, suggesting that anxiety screening and anxiety interventions may be most resourcefully used in the first trimester for Latina women in particular.

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Funding

1 R03 HD095056, NIH-NICHD.

University of Illinois at Chicago Center for Clinical and Translational Science (CCTS) award UL1TR002003.

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Correspondence to Pauline M. Maki.

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Conflict of interest

Author RDG has been an expert witness for the US Department of Justice, Merck, Glaxo-Smith-Kline, Pfizer, and Wyeth and is a founder of Adaptive Testing Technologies, which distributes the CAT-MH™ battery of adaptive tests. The terms of this arrangement have been reviewed and approved by the University of Chicago in accordance with its conflict of interest policies.

Author PMM has served as a consultant for Astellas, Johnson & Johnson, Pfizer, Abbott, and Balchem.

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Wenzel, E.S., Gibbons, R.D., O’Hara, M.W. et al. Depression and anxiety symptoms across pregnancy and the postpartum in low-income Black and Latina women . Arch Womens Ment Health 24, 979–986 (2021). https://doi.org/10.1007/s00737-021-01139-y

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  • DOI: https://doi.org/10.1007/s00737-021-01139-y

Keywords

  • Perinatal
  • Depression
  • Anxiety
  • Adaptive tests
  • Longitudinal
  • Race
  • Ethnicity